We propose creating a shared computing resource to support research activities in biomedical informatics at the Stanford University School of Medicine. The School has established the Center for Advanced Medical Informatics at Stanford (CAMIS), which unites academic, administrative, and research computing. The requested funds will support an active core research program and the infrastructure and day-to-day computing needs of a large number of researchers, each of whom has external support from NIH or other agencies through grants or contracts. No single research group could support the complex set of infrastructural and system capabilities needed to conduct advanced medical informatics research in the 1990's. Our approach to designing, managing, and building the CAMIS resource will be guided by a number of overall goals: (1) to foster scientific communication, collaboration, and sharing within a distributed research environment; (2) to provide a superb setting for exploring biomedical informatics topics; (3) to pursue a strong basic replications systems; (4) to help define new ways to disseminate computing and information-management technologies into real-world settings; and (5) to create a state-of-the-art computing and communication environment for our research work. The specific aims for this undertaking fall under four categories that define the functions of the CAMIS resources: Core Research and Development: We are proposing core research projects in several areas: (1) Clinical Trials Workstation (CTW) Project-generalize and abstract system-design concepts and implementation solutions from our ONCOCIN and T-HELPER projects so that they can be applied to facilitate the most rapid development of integrated clinical-trials workstations in any domain of clinical-trials management; (2) Understanding the Code for Biological Molecules--development and generalize improved tools for discovering and for understanding the structure relationships so these can be used to understand the functions of genes identified in genome mapping investigation; (3) Advanced Computing Systems and Environments--build upon the extensive distributed-computing environment already in place and improve, extend, and adapt new computing tools as necessary to support the CAMIS community. Specific systems research areas include gesture-based portable computing information resource navigation and retrieval tools, email management tools, high-speed networks, large-volume file storage, and new workstations technologics. Collaborative Research: A large community of researchers will be supported by the CAMIS resource, doing work in areas such as clinical trial protocol management, methods for uncertain reasoning, bioinformatics, health care outcomes and economics, basic artificial intelligence research, human-computer interfaces, multimedia authoring and delivery tools for medical education programs, and distributed library resources. We will accordingly encourage collaborations through improved mechanisms for inter- and intra-group communications. Service and Resource Operations: CAMIS will provide effective and widely accessible communication and computing facilities, consulting services, and managerial support and will serve in an advisory capacity to Medical School administration. Training, Education, and Dissemination: CAMIS will emphasize a strong user orientation in its facilities management, will continue to run two formal graduate degree programs (one in medical informatics and one in health services research), and will actively disseminate research results through publications, software exports, video presentations, visiting scholar programs, and an annual CAMIS Symposium.